Harnessing the Microbiome in Cancer Immunotherapy: Regulation, Prediction, and Therapeutic Targeting

Area of Science:

• Microbiome research
• Cancer biology
• Immunotherapy

Background:

• Humans are metaorganisms, with a significant microbial component (microbiome) influencing health.
• The microbiome plays a role in cancer initiation, progression, and response to therapy.
• Understanding the host-microbiome interaction is crucial for advancing cancer treatment.

Purpose of the Study:

• To review the role of the microbiome in cancer as a metaorganismal disease.
• To summarize evidence on microbiome-based prediction of immunotherapy response and adverse events.
• To highlight the therapeutic potential of microbiome modulation in cancer immunotherapy.

Main Methods:

• Literature review of studies on the microbiome and cancer.
• Analysis of machine learning models predicting immunotherapy outcomes based on microbiome data.
• Review of clinical trials investigating fecal microbiome transplantation (FMT) in cancer immunotherapy.

Main Results:

• Machine learning models moderately predict clinical response and immune-related adverse events using microbiome features.
• Fecal microbiome transplantation combined with PD-1 therapy improved outcomes in refractory patients and showed efficacy as a first-line treatment.
• The microbiome impacts multiple facets of cancer, including genome stability, inflammation, immunity, and metastasis.

Conclusions:

• The microbiome is an integral factor in cancer development and immunotherapy response.
• Microbiome modulation, particularly FMT, offers a promising strategy to enhance cancer immunotherapy efficacy and safety.
• Further research is needed to overcome challenges and fully leverage the microbiome's therapeutic potential in oncology.